Mid- to long-term results of the Remeex system for the treatment of female incontinence due to intrinsic sphincter deficiency: A retrospective analysis of the first 50 patients.

Aims: To retrospectively report our mid- to long-term results following suburethral tension adjustable sling (Remeex system) implantation for stress urinary incontinence (SUI) due to intrinsic sphincter deficiency (ISD).

Methods: Fifty female patients with severe SUI due to ISD underwent Remeex system positioning between May 2002 and March 2013 (mean follow-up 83.8 months, median follow-up 85.4 months). Before surgery, patients were evaluated by physical examination, translabial ultrasonography, cystoscopy, urodynamics, 1 hr pad test and compilation of quality-of-life questionnaire. Postoperatively, based on the physical examination and pad test, patients were stratified into three groups: (i) Cured: perfectly dry patients at stress test, pad weight 0-1 g; (ii) Improved: patients with mild to moderate incontinence, pad weight 2-50 g; and (iii) Failed: unchanged or worsened patients, pad weight >50 g.

Results: At 7-years mean follow-up, 45 (90.0%) patients were cured, three (6.0%) were improved, and two (4.0%) had failed. Concerning the mean total score of the quality-of-life questionnaire, it increased significantly up to 87.1 ± 5.9 with an improvement of 76.9%. Sling tension readjustment was needed in three patients (6%). The incontinence-free survival curve showed that, after sling positioning and tension readjustments, all the cured patients remained continent during all the follow-up. Complications were represented by bacterial cystitis (6%), de novo urgency (10%), persistent urinary retention (6%), and seroma formation (2%).

Conclusions: Our 7-year results showed the efficacy of the Remeex procedure in the treatment of SUI due to ISD. These outcomes tended to be confirmed in the mid- to long-term follow-up which would highlight the durability of this technique. Neurourol. Urodynam. 36:770-773, 2017. © 2016 Wiley Periodicals, Inc.